Clinically important abnormalities are common in senior cats perceived to be healthy by owners.

Routine screening of senior cats is essential, as owner-reported health status consistently underestimates significant underlying disease.

This prospective cohort study evaluated 129 client-owned cats aged ≥12 years presented to the University of Wisconsin-Madison School of Veterinary Medicine between 2022 and 2024. All cats were perceived as healthy by their owners, though those with stable chronic conditions were eligible for inclusion. The study aimed to characterize the discordance between owner perception and objective clinical findings to guide diagnostic prioritization within a spectrum-of-care framework. Physical examination revealed abnormalities in 100% of cats, with dental disease present universally and orthopedic disease identified in 77.8% of evaluated cats. Diagnostic testing uncovered high prevalences of previously unrecognized conditions: chronic kidney disease (CKD) in 61.3%, hypertension in 96.4%, and hyperthyroidism in 64.7% of tested cats. Owner-reported mobility scores failed to correlate with orthopedic findings, and owner-reported clinical signs substantially underestimated disease burden—75.6% of CKD-affected cats had no reported change in urination, and only 1.3% had reported increased thirst. The most diagnostically informative modalities were physical examination, urine specific gravity, renal biomarkers, total T4, and blood pressure measurement. These findings underscore the inadequacy of relying solely on owner-reported observations for disease detection in senior cats. The authors advocate for routine screening protocols prioritizing these accessible diagnostics, even when financial or logistical constraints preclude comprehensive workups. This study provides strong evidence supporting proactive preventive care for senior cats regardless of perceived health status.

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